The much hyped Arogyasri Health Insurance Scheme in Andhra Pradesh is expected to go for a comprehensive revision of the package rates for the entire spectrum of procedures under the scheme.
In this regards, the Arogyasri Trust has set up a committee to look in to the matter and suggest viable ways to reach at a suitable solution and meet the growing demands of private hospitals which are asking for hike in packages rates for healthcare services in the state.
The Arogyasri healthcare scheme was first launched in the state in 2007. The main aim of the scheme is to provide quality healthcare services to the poor patients living under the below poverty line (BPL). Under this scheme the poor patients are given Rajiv Arogyasri Health Insurance Cards, upon submitting this card to any recognized private, multi-specialty or government hospital, the poor patient can avail treatment free of cost. The entire costs for his treatment will be born by the government. There have been more than 940 ailments being treated under this scheme.
While this is the scenario, for a long time now, there has been a growing demand from private hospitals to hike the package rates by 20 to 25 per cent as the costs of the drugs and disposables have increased.
The committee consisting of government and private representatives from hospitals and the health directorate will work out the logistics and fix the rates based on the procedures. The committee constitutes representatives from teaching hospitals under the directorate of medical education, health directorate, AP Vidya Vidhana Parishad and association of private nursing homes. One of the committee members said, “There would be revision of rates for most of the procedures especially those which are more commonly performed. There’s a need for revision of rates since prices of all consumables, drugs and disposables have gone up in the last five years. However, hike in rates would be determined after a detailed revision of each procedure and packages.”
Meanwhile, a study team from Ghana also visited the Gandhi Hospital and KIMS Hospital to study the Arogyasri procedure. The team was impressed after finding out how the unique government scheme in collaboration with a private insurance company works in the arena of reauthorizations, claiming, packages, and payment to hospitals and so on.